Zinc Shortage Linked to Zinc Deficiency Disorder in Infants on Parenteral Nutrition — Physician’s First Watch
Zinc Shortage Linked to Zinc Deficiency Disorder in Infants on Parenteral Nutrition
By Cara Adler
Nationwide shortages of injectable zinc, a component of parenteral nutrition, have led to zinc deficiency disorder in seven infants with cholestasis, according to MMWR.
The shortage began in late 2012, when one of two U.S. producers experienced manufacturing delays. The CDC investigated three cases of zinc deficiency reported in Washington, D.C., in December 2012 and four reported in Houston in January 2013. The infants were given parenteral nutrition without zinc after the hospitals had run out of supplies. Severe dermatitis, bacterial infections, or both, developed 4 to 34 weeks after parenteral nutrition was started. Other known complications of zinc deficiency include liver and kidney failure.
The FDA is allowing importation of injectable zinc until domestic supplies are restored (a link to FDA information on availability is provided below). In the meantime, the authors recommend that clinicians reserve limited supplies for the highest-risk infants (premature, very low birth weight, gastrointestinal dysfunction) and monitor patients who receive parenteral nutrition without zinc for signs of deficiency.